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Escape from HealthCare.gov: New Mexico shops for an enrollment system

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The board of the New Mexico Health Insurance Exchange is trying to go where other exchange boards have gone before — with fewer glitches.

The exchange board is hiring a project manager to set up an individual exchange enrollment from the state’s Be Well PPACA exchange system.

The state has been supporting its exchange and running Small Business Health Options Program (SHOP) enrollment, but it has been using HealthCare.gov, the enrollment system for the exchanges managed by the U.S. Department of Health and Human Services (HHS), to handle individual enrollment.

Other states that have set up their enrollment systems have had mixed results.

Some states, such as Connecticut and California, have been happy with the performance of their homegrown enrollment systems much of the time. Some states, including Massachusetts and Oregon, have been so unhappy with their enrollment systems that they have shifted from using homegrown systems in 2014 to using HealthCare.gov or systems from other vendors this year.

To learn what New Mexico has done with its project manager request for proposals (RFPs) to try to limit risk, read on.

Workers

1. The board seems to be limiting the pool of potential vendors to companies that know it well.

The exchange board posted the RFP Dec. 5 and wants to get proposals by 3 p.m. Mountain Standard Time Dec. 18.

Companies have to be available for onsite interviews Dec. 30.

“Offerors will be asked to begin working immediately after signing a contract,” officials say in the RFP.

The winner is supposed to get an exchange enrollment system running for the 2016 open enrollment period.

Agents and brokers are not eligible to submit a proposal.

See also: Why don’t brokers love PPACA small-group exchange programs?

Hand with pen and paper

2. The board is asking for implementation details.

The exchange wants a detailed milestone timeline and a detailed price proposal along with a description of any relevant PPACA-related or other exchange-related experience.

The RFP response is also supposed to include information about any sanctions, disciplinary actions, defaults, threatened litigation or other problems going back 10 years.

See also: Low-cost CO-OPs win share

Man peering through blinds

3. The board is reserving the right not to accept any applications and is warning that it will check references.

The board says it reserves the right to obtain information about the applicant and the applicant’s subcontractors from any source; that it may reject proposals that fail to comply with the terms of the RFP without evaluating them; and that it may not end up awarding a contract.

See also: New Mexico exchange close to hiring marketing help

CORRECTION: An earlier version of this article described the Massachusetts exchange enrollment system choice for 2015. Massachusetts has changed vendors but continues to operate its own enrollment system.


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